Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study
Open Access
- 15 October 2013
- Vol. 347 (oct15 7), f5961
- https://doi.org/10.1136/bmj.f5961
Abstract
Objective To determine the risk of chronic kidney disease in patients with psoriasis. Design Population based cohort study and nested cross sectional study. Setting Electronic medical records database based in United Kingdom. Participants Cohort study: patients with psoriasis aged 18-90 each matched to up to five patients without psoriasis based on age, practice, and time of visit. Nested study: patients with psoriasis aged 25-64 with confirmed data on psoriasis severity, each matched to up to 10 patients without psoriasis based on age and practice. Main outcome measures Cohort study: incident moderate to advanced (stage 3 through 5) chronic kidney disease. Nested study: baseline prevalence of chronic kidney disease. Results 136 529 patients with mild psoriasis and 7354 patients with severe psoriasis based on treatment patterns were matched to 689 702 unaffected patients. The adjusted hazard ratios (95% confidence intervals) for incident chronic kidney disease were 1.05 (1.02 to 1.07), 0.99 (0.97 to 1.02), and 1.93 (1.79 to 2.08) in the overall, mild, and severe psoriasis groups, respectively. Age was a significant effect modifier in the severe psoriasis group, with age specific adjusted hazard ratios (95% confidence intervals) of 3.82 (3.15 to 4.64) and 2.00 (1.86 to 2.17) for patients aged 30 and 60, respectively. In the nested analysis of 8731 patients with psoriasis with measurements of affected body surface area matched to 87 310 patients without psoriasis, the adjusted odds ratios (95% confidence intervals) for chronic kidney disease were 0.89 (0.72 to 1.10), 1.36 (1.06 to 1.74), and 1.58 (1.07 to 2.34) in the mild, moderate, and severe psoriasis groups, respectively. Conclusions Moderate to severe psoriasis is associated with an increased risk of chronic kidney disease independent of traditional risk factors.Keywords
This publication has 40 references indexed in Scilit:
- Medical comorbidity associated with psoriasis in adults: a population-based studyBritish Journal of Dermatology, 2011
- Calcineurin Inhibitor NephrotoxicityClinical Journal of the American Society of Nephrology, 2009
- The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: Results from NHANES 2003-2004Journal of the American Academy of Dermatology, 2008
- Validation studies of the health improvement network (THIN) database for pharmacoepidemiology researchPharmacoepidemiology and Drug Safety, 2006
- IgA nephropathy associated with psoriasis vulgaris: a contribution to the entity of 'psoriatic nephropathy'.2006
- K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.2002
- Hyperuricemia in psoriatic arthritis: prevalence and associated features.2000
- Renal Involvement in PsoriasisDermatology, 1996
- IgA nephropathy associated with hyper IgAnemia, psoriasis or pustulosis and ossification.1995
- Membranous nephropathy associated with psoriasis vulgaris.1994